A new study focuses on the mental health of teenagers — particularly those who have a family member deployed in the military. The research found that teenagers who had a family member in the military were more likely to experience depression, hopelessness and suicidal thoughts than their peers whose family members weren’t in the military.

“One of the goals of our research was to highlight kids’ experiences, which have been unintentionally ignored in the past,” Julie Cederbaum, assistant professor of social work at the University of Southern California in Los Angeles, told Reuters. The authors note that overall, mental health is already a major public health concern; adolescents who are related to military personnel, in particular, have an increased risk for mental health issues.

“There is the stress of being concerned and worried about the parent or sibling who has been deployed,” Cederbaum told Reuters. “While contact has improved drastically, you don’t always know how well they are doing.” The study involved an extra questionnaire that was added to a statewide survey that is typically administered every two years in California public schools. Some 14,300 students were surveyed, and under 14 percent of them had a family member in the military. In general, 28.5 percent of U.S. teenagers report feeling sad or hopeless, while 33.7 percent of adolescents with a parent in the military — and 35.3 percent with a sibling in the military — report feelings of sadness or hopelessness.

Children whose family member is abroad in the military may also be likely to experience isolation; according to the Pew Research Center, less than one percent of the U.S. population is on active duty at any point in time. Without many peers who share the same experience, these children may feel isolated and lonely, the researchers claim. “Part of the experience of depression can be isolation,” Cederbaum told Reuters. “Kids need to be able to connect with one another and know that others feel the way they do.”

Commander Dr. Gregory Gorman, a Navy pediatrician at the Walter Reed National Military Medical Center, told Reuters that the study “collected data a little further away from the height of the wars. It shows us that these are persistent symptoms.” Dr. Gorman was not involved in the study. Pediatricians and primary care doctors should be aware of this particular population, Gorman noted. Likewise, the authors of the study mentioned that there are plenty of things school districts can do to become more aware of the issue and provide support for this teenage population. “Although deployment-related mental health stressors are less likely during peace, during times of war there is a need for increased screening in primary care and school settings,” the authors of the study write in their conclusion.

Source: Cederbaum J, Gilreath T, Benbenishty R, et al. Well-Being and Suicidal Ideation of Secondary School Students From Military Families. Journal of Adolescent Health. 2013.